Announcements
IMPORTANT ANNOUNCEMENT UPDATE: As of 06/26/2025, HealthCare Authority Provider Enrollment is continuing to experience up to an 8 MONTH delay processing Core Provider Agreements, a final part of the application process. This delays the contractors’ ability to access the Social Service Medical Profile and bill. You SHOULD NOT start working with Medicaid clients OR accept new referrals UNTIL you are able to log into ProviderOne, view your authorizations list & have a Social Service Medical profile. We do understand the severity of this delay and want to be transparent with applicants. Please understand that if you contract with DSHS as a Nurse Delegator, you may be subject to these delays.
The DSHS Nurse Delegation Program supports DSHS Community-Based Residential Care settings. This includes In-Home services. Adult Family Homes, and Certified Residential Developmental Disabilities Community Services. The Orientation training is for Registered Nurses interested in becoming a DSHS contracted registered nurse delegator. This is not a certification class, it is information and required for contract.
What Is Nurse Delegation in the Community Residential Setting?
The DSHS Nurse Delegation Program, under Washington State law, allows credentialed and trained Nursing Assistants and Home Care Aides working in DSHS Community-Based Residential Care settings to perform certain tasks. Examples include administration of medications and blood glucose testing which are normally performed only by licensed nurses. A Registered Nurse must teach and supervise the Nursing Assistant or Home Care Aide, as well as provide nursing assessments of the patient's condition. Registered Nurse delegation is governed by many laws, rules, and policy regarding licensing, credentialing, training, and for each setting.
Nurse Delegation (ND) Links
- Contractor Meeting notes
- HCS Management Bulletins
- 2025 Calendar of Events
- Skin Observation Protocol Resources
- SOP Training
- RCW 18.79.260 Registered nurse—Activities allowed—Delegation of tasks
- WAC 246-840-910 - 970 Delegation of Nursing Care Tasks in Community-Based and In-Home Care Settings
- RCW 18.88A Nursing Assistants
- RCW 18.88B Long-Term Care Workers
- Aging and Long-Term Support Administration Long-Term Care Manual
- Developmental Disabilities Administration Nursing Services
- DOH Provider Credential Search
How to Become a Registered Nurse Delegator
As of 6/26/2025, the Registered Nurse Delegation Orientation training for the rest of 2025 has been cancelled.
We will resume the training in January 2026. Registration access for January to July 2026 will be posted December 1, 2025. We will provide 6-hour classes every other month in different locations around the state. Locations are dependent on availability for class space. Most classes are limited to 30 participants and registration typically fills up fast.
Please do not reach out to us to request being put on a list. There is no waiting list.
For your information, Registered Nurse Delegation Orientation training handouts can be accessed here: Registered Nurse Delegation Orientation Handout
FREQUENTLY ASKED QUESTIONS:
How Can a Registered Nurse Contract with DSHS To Provide Nurse Delegation?
Registered nurses who wish to contract with DSHS are required to attend an all-day in-person training session provided by the DSHS Nurse Delegation program. The RN must also complete a contract packet which you will receive after attending the class.
What Is Required for a Registered Nurse to Provide Nurse Delegation?
All Registered Nurse’s in Washington State may delegate, however they may only do so according to the laws (RCW 18.79.260) and regulations (WAC 246-840-910 to 970) upheld by the Washington State Board of Nursing.
To delegate to DSHS Medicaid clients the RN must have an active DSHS ND contract.
How does an RN Contractor find clients?
DSHS does not automatically provide clients to the delegator; the delegator must market their services for themself. DSHS does distribute the current list of Contracted Nurse Delegators to DSHS Case Managers who authorize Nurse Delegation services for Medicaid clients qualified for services.
The DSHS contracted nurse delegator receives authorization for services for state Medicaid clients from Case Managers in Home and Community Living Administration and Developmental Disabilities Community Services. The contractor submits time through Health Care Authority and ProviderOne for payment of services.
How does the Nurse Delegator get paid for delegation services?
The DSHS contracted nurse delegator receives authorization for services for state Medicaid clients from Case Managers in Home and Community Living Administration and Developmental Disabilities Living Administration. The contractor submits time through Health Care Authority and ProviderOne for payment of services.
How Do I Get Nurse Delegation Forms?
You can download all mandatory forms at the Nurse Delegation Forms page. The forms provided are mandatory by contract.
How Do I Find Classes?
Classes are closed until January 2026. New registration will be found here on December 1, 2025. Please do not reach out to request to be on a list as we cannot keep a list for this purpose. The class has first come first serve registration.
The class training material is available for viewing and downloading here: Registered Nurse Delegation Orientation Handout
DSHS has contract option for Private Duty Nursing and Skilled Nursing. Please see the links below for more information:
- Private Duty Nursing contract information
- Skilled Nursing Area Agency on Aging contract information